Behrooz Ebrahimi-Fard, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

220273-1 Issued in NY

Practice address

100 Park St
Glens Falls Hospital - Behavioral Health Serv
Glens Falls, NY 12801-4413

Phone

(518) 926-3210

Fax

(518) 926-3215

NPI assigned

May 16, 2006

Last updated

Jan 3, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Icahn School of Medicine at Mount Sinai

  dba Psychiatry Department of Mount Sinai

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • New York, NY
  • NPI 1033482518
  NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Arnot Ogden Medical Center

  • General Acute Care Hospital
  • Elmira, NY
  • NPI 1083605661
  NPD (past)
• Chemung Medical Services PC

  dba Arnot Medical Services

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1356378889
  NPD (past)
• SLR Psychiatric Associates

  • General Acute Care Hospital
  • New York, NY
  • NPI 1164453312
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1700838158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BROAD STREET PLZ",
            "address_2": "ADIRONDACK MEDICAL SERVICES",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014369",
            "telephone_number": "518-926-5924",
            "fax_number": "518-926-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK ST",
            "address_2": "GLENS FALLS HOSPITAL - BEHAVIORAL HEALTH SERV",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-3210",
            "fax_number": "518-926-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIMI-FARD",
        "first_name": "BEHROOZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "220273-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02300461",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Dunkley, PT, DPT
• Anna Dyakova, PA
• Ann Dys, FNP
• Michelle L Eastman, NNP
• Michaela Jean Ebert, MS, OTR/L
• Eckerd Corporation (Rite Aid Pharmacy 10717)
• Eden Park Health Services, Inc.
• Jocelyn Paige Edens, CNM
• Lynn Edgerly, LCSW R
• Joanne Egnaczyk, LPN

• Psychiatry Physician in Glens Falls, NY
• Providers in Glens Falls, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.